Did you know more than 41 million Americans needed substance use treatment in 2020 according to the Substance Use and Mental Health Services Administration (SAMHSA)?
Those who attend treatment have several levels of services available to them. These include outpatient (also called an OP program), intensive outpatient (also called an IOP program), and inpatient/residential treatment.
Each of these substance use programs has different requirements that must be met to determine the level of care needed for the client.
Read on for a guide to substance use programs and to learn which type might be right for you.
When Is Substance Use Treatment Necessary?
Determining if it is time to attend substance use treatment can be a difficult step at any time in your life. You may feel that your use of alcohol or marijuana is no more than anyone else’s, yet you may have friends and family telling you they are concerned.
One question to ask yourself is whether your drug or alcohol use is negatively impacting areas of your life.
Think back a week, or even a month, have you had to miss work due to your drinking or drug use? Have any of your relationships been negatively affected?
Do you think about alcohol or substance use more often than you would like?
Has your health been impacted by your drug or alcohol use?
Do you spend less time with your friends or family now than you used to because you are drinking or using a substance?
Have you skipped out on any responsibilities (picking kids up from school, missing meetings at work, choosing not to clean up around your home) to drink or use drugs?
If the answer is yes to any of these questions, it is likely time to admit you may have a substance use problem.
The next step is to make a plan for how you will get sober.
If you believe you may need help to get sober, it is important to consider treatment. Studies show that as many as 38 million people had a substance use disorder in 2020 and did not receive help for those concerns.
Most professionals agree that if you think you might need help to get sober, you most likely do.
What Are the Levels of Substance Use Treatment?
There are three basic levels of substance use treatment:
- Outpatient Treatment (OP)
- Intensive Outpatient Treatment (IOP)
Each of these levels offers different things within their care programs and meets patients where they are in their recovery.
Typically, unless you are court-ordered to a specific level of care, you can choose the level of care you feel will best meet your needs.
What Exactly Is Outpatient Substance Use Treatment?
Outpatient (OP) Treatment is the first level of care for patients struggling with alcohol or drug addiction.
Depending on the state you live in, these programs require approximately four hours of therapy each week. These hours will be filled with a combination of individual therapy and group therapy.
Outpatient programs typically run for sixteen to eighteen weeks. The length of the program is set by the treatment facility you choose.
How Does an Outpatient Program Work?
OP Treatment allows you to begin building a new schedule that includes your treatment group and therapy while continuing with many of your normal daily activities, such as work.
Outpatient treatment brings many new supportive persons into your life. These will include professionals such as therapists, doctors, and potentially court-ordered staff, depending on your situation.
It will purposefully introduce you to new sober supports who may eventually become friends. It is important that your sober support network grows during this time so that when treatment ends, you have people to lean on when needed.
Outpatient treatment can also be a great option if you need telehealth services. There are several reasons telehealth might be necessary. These include:
- You live too far to commute daily to a treatment facility
- You do not have transportation
- Your health does not allow you to attend appointments regularly
What Are the Benefits of OP Treatment?
There are many advantages to taking part in treatment on an outpatient basis. One main benefit is that many OP programs are built to work around the work lives of patients.
This may mean that they offer therapy in the early morning and evening hours. Treatment centers may also offer telehealth options with appointments available over lunch hours.
Another benefit is receiving both group and individual therapy. Group therapy is helpful for gaining multiple perspectives on how substances have affected lives and how others are working their way through recovery.
Individual therapy is beneficial for guidance in helping you determine what led to self-medicating using alcohol or drugs. Your therapist can help you learn new coping techniques and become mindful of your relapse triggers.
Yet another benefit of outpatient treatment is the people you meet there. These new contacts often become the sober supports who will be there for you when you are on the brink of relapse. They understand your struggle and are looking for your support as well.
Who Is Outpatient Substance Use Treatment Meant For?
OP Treatment is meant for those in a mild stage of their substance use disorder. Depending on the type of substance used, the frequency of use, and if only minor disruption has been caused in your life, outpatient treatment may a fitting level of care.
Outpatient treatment is also used as a step-down program from a higher level of care. Once a patient has completed Intensive Outpatient Treatment, and possibly Inpatient treatment as well, they are ready to step down and complete OP treatment.
This gives the patient continued structure and support, but at a lesser intensity of care. It enables them to be working and fully reengaging with their life in a sober way, and with support in place.
Some clients choose to live in a sober living environment during their time in outpatient treatment to eliminate distractions and for additional accountability.
Where Can You Find Outpatient Substance Use Treatment?
There are several places where OP treatment programs can be found, such as hospitals and community mental health agencies. There are also private practice substance use counselors within every community that offer treatment programs.
Another place to find outpatient programs is in residential facilities. Most facilities that offer inpatient substance use treatment also offer outpatient treatment.
You might search for “sober living homes near me,” “drug rehab NJ,” or “outpatient treatment near me” to find OP substance use treatment in your area. You might also try searching for “telehealth addiction treatment” if you need to be seen online due to transportation or health needs.
What Exactly Is Intensive Outpatient Substance Use Treatment?
Intensive Outpatient (IOP) Treatment is the middle level of care for those struggling with substance use.
Each state sets its own requirements, but typically IOP programs meet for ten hours a week. This includes one hour of individual therapy and three three-hour group sessions.
How Does an IOP Program Work?
Intensive Outpatient treatment consists of three to four days of programming which help you to immerse yourself in treatment while still living at home.
IOP programs allow clients to integrate their current work or school obligations with treatment. IOP will also help you build a sober support system and social life, which may differ greatly from what it looked like prior to treatment.
During Intensive Outpatient treatment you will meet for group therapy three times a week. During group therapy, you will discuss relapse prevention, triggers to be mindful of, and self-care ideas.
Group often utilizes behavior modification therapy to teach you skills that will help you be successful in recovery. They might also use cognitive behavioral therapy for addiction.
You will also meet with your individual therapist once weekly. Your therapist will work with you to create a treatment plan specific to you and your recovery.
What Are the Benefits of IOP Treatment?
There are many benefits when it comes to Intensive Outpatient care. The first is having chunks of time dedicated to your recovery each week. Not only does this help patients focus on sobriety, but it also helps them to regularly be in the presence of other sober individuals.
Another benefit of IOP is that it allows you to maintain the support of your family even while in recovery. Because you are in treatment on an outpatient basis, you can be in close contact with your sober, supportive family members. You are able to maintain your household, be with your children, and have the support of your loved ones.
Intensive Outpatient treatment is also less costly than a residential treatment program. This can be very beneficial depending on your insurance and co-pay.
Who Is IOP Meant For?
Intensive Outpatient treatment is for those clients who are struggling with a substance use disorder but do not meet the criteria for residential treatment. IOP is also used as a step-down program for anyone who has completed an inpatient program and is ready for a lower level of care.
IOP is for patients who are struggling with mild to moderate substance use disorders. It is important to remember, however, to be realistic with how you will handle the freedom IOP offers.
Be honest with yourself and your therapist about any triggers that will be present in your home or work environment. Make a plan to address your triggers and cravings so that you can be successful in treatment.
Where Can You Find Intensive Outpatient Substance Use Treatment?
Much like outpatient treatment programs, you can find IOP programs in places like hospitals and community mental health clinics. You can also look for private practice substance use counselors in your community who have put together their own treatment programs. Residential treatment facilities often offer IOP programs as well.
You might search for “intensive outpatient program near me,” “intensive outpatient depression program near me, “partial care programs in NJ” to find great programs in your local area.
What Exactly Is Residential Substance Use Treatment?
Residential treatment, which is also called inpatient treatment, is an inpatient treatment program where you live full-time at the facility.
Often a residential treatment program is necessary after a crisis, such as an overdose. It can also be helpful to begin in an inpatient setting if you need to detox from the substance you have been using.
Residential treatment programs run anywhere from 28 days to a year. The length of your stay depends on many things including the programming of the facility, the severity of your substance use disorder, progress made during treatment, and other factors.
How Does Residential Treatment Work?
When you are taking part in a residential treatment program, you will participate in many different types of activities including therapy and relapse prevention classes.
As in outpatient treatment, you will attend both group therapy as well as individual therapy. Group therapy is an important piece of treatment to help participants begin both learning as well as practicing recovery strategies. Depending on the residential program you choose, you may also have the opportunity to take part in family therapy.
Many residential programs will also have daily classes on topics specific to issues that relate to mental health. These may include anger management, coping with grief, dealing with stress, or other similar topics.
What Are the Benefits of Residential Treatment?
There are several benefits of attending a residential treatment program, not the least of which is the structure it provides. Having structured time away from your daily norm can, at times, be beneficial to help you create new patterns and habits for your life.
Another great benefit of residential treatment is the community to be found there. Finding like-minded souls who are struggling in some of the same ways you are can be very healing.
These people may potentially become sober supports who carry into your new daily routine at home as well.
One more benefit of residential treatment is the ability to focus solely on your recovery. Treatment covers a lot more than just becoming sober.
You will be working on many other pieces of your life while in therapy. Taking some time away from your life to completely focus on healing is worth considering.
Who Is Residential Substance Use Treatment Meant For?
Residential treatment is an intensive, long-term program for those with severe substance use disorders.
Inpatient treatment requires you to check yourself in and agree to live in a controlled, sober environment for the duration of your recovery program. You will want to make any necessary arrangements with your employer and family to be away during this time.
It will also be important for you to speak with your chosen facility to learn their policy on family contact. Some facilities even offer family therapy, which you may want to arrange before you arrive.
Where Can You Find Inpatient/Residential Substance Use Treatment?
Residential substance use treatment can be found in privately-run or corporate-owned facilities with licensed staff. Some hospitals also offer inpatient substance use treatment programs.
How Is Level of Care Determined for Treatment?
Before entering treatment, you typically need to have a substance use evaluation.
A substance use evaluation is an appointment during which a substance use therapist gathers your mental health and substance use history, current use, and symptomology. You will also be required to fill out a series of assessments to help determine your substance use severity.
Based on all the information gathered, as well as the ASAM criteria, the substance use therapist will put together your evaluation.
Once the substance use therapist has completed their evaluation, they will make a recommendation for which level of care is the best fit for you.
What Are the ASAM Criteria?
The ASAM (American Society of Addiction Medicine) Criteria are a set of guidelines that are used by therapists that work in the addictions field. They help with the placement, transfer, and discharge of patients with substance abuse and co-occurring disorders.
Therapists who are licensed in the substance use field or who are dually licensed can become ASAM Certified by taking classes in the use of this criteria. This training helps therapists with connecting clients with the proper level of care.
The ASAM covers six dimensions of a client’s life:
- Acute Intoxication/Withdrawal
- Medical Conditions/History
- Mental Health History
- Readiness to Change
- Relapse and/or Continued Use Projection
- Current Living Environment
Each of these areas gives the therapist a window into an area of the client’s life. The therapist takes all six dimensions into account, as well as the client’s evaluation as a whole, before making a recommendation on the level of care.
What Type of Topics Are Covered in Substance Use Treatment?
The topics covered in substance use treatment are to help you live a more effective and well-balanced sober life. You will also find that topics address substance use issues directly to help you manage things like triggers and cravings when they occur.
Here are a few of the many topics covered in substance use treatment:
Relapse prevention skills help you to build a stable foundation for your recovery. These skills aid you in learning to manage your downtime and learning the importance of having a sober social support network.
You will work to put together a relapse prevention plan that you can turn to when you experience cravings, triggers, and other moments of struggle.
This unit may also cover setting boundaries with friends and family members. Another aspect of relapse prevention is managing work, family, and recovery.
Stages of Change
There are five stages of change that are covered with the participants of substance use treatment. It is important to become familiar with this concept and identify what stage of change you are currently in. This may also help you to move through the other stages of change.
The five stages of change are:
- Precomtemplation: The costs of the behavior are not yet high enough to be acknowledged.
- Contemplation: There is reason to change, but some hesitance as well.
- Preparation: The decision to change has been made, and thinking about how to change has begun.
- Action: Work to change has started.
- Maintenance: Change made during the Action phase is now being maintained.
Boundaries are an issue for many people who struggle with substance use disorders. Part of the issue in addiction is a loss of boundaries both with ourselves and with the substances abused.
Because of this, learning to set healthy boundaries is an important part of recovery. It can be difficult, especially when you first begin, but it is worth it for peace of mind long term.
Coping With Stress
Learning to recognize and manage your stress is another important topic. Unfortunately, stressors and challenges in life continue even after treatment.
Learning new coping skills and methods to better deal with stress can help you be prepared. This might mean adding new skills might be adding hobbies, exercise, and other pleasant events to your life.
Handling Anger and Difficult Emotions
Anger and other difficult emotions are many times what lead people to relapse. Learning how to manage these emotions is an important piece of recovery and is preventing relapse long-term.
Some questions posed might be:
- How do you recognize when you are angry? Sad? Other difficult emotions?
- How do you express anger?
- How do you express other difficult emotions?
- What positive ways do you use to cope with anger or other difficult emotions?
Many times relationships are under a lot of stress when substances are being misused. In treatment, we look at how to go about repairing injured relationships, learning to say no to people in our lives, and how to make new friendships.
One of the relationships that can be injured is our relationships with ourselves. We must relearn not only to trust others but to rebuild and repair trust in ourselves.
There is a lot of stigma surrounding mental health and substance use disorders. When we enter treatment, we may feel people are judging us. We may also find ourselves using harsh words and negative thoughts against ourselves.
It is important to take time to learn to extend compassion toward ourselves. Only then can we move forward in a positive and changed manner.
Coping With Boredom and Complacency
If you are new to recovery it may sound silly, but the truth is that boredom can often lead to relapse. We must learn the dangers of boredom in recovery and how easy it is to make impulsive and unwise decisions when feeling bored.
That rush of dopamine isn’t worth the consequences of overspending or relapsing. So, we must learn to recognize the signs and make a plan of what we will do instead.
When deep in our substance use disorder, we lose sight of who we truly are and what our values are. Our values are the things we hold as true and most important to us.
When we know our values, we can use them to make better decisions. In recovery, we can reexamine our values as a way to get to know ourselves better once again.
Do You Need to Detox Before Going to Treatment?
Detoxing is the term for the time period when you are removing all substances that you are addicted to from your body.
This detoxification process can produce withdrawal symptoms and so it may need to be done in medical care.
Withdrawal symptoms can look like this:
- Sleep issues
- Appetite loss
- Heart Palpitations or rapid heartrate
Your withdrawal symptoms can run anywhere from mild to severe.
How severe your detox is may depend on the substance you are withdrawing from. It will also depend on how much of the substance is in your system when you arrive at detox. Another factor can be how long you used the substance in question.
Outpatient programs and intensive outpatient treatment programs will require that you have gone through detox before you begin.
Depending on the facility you choose, some residential programs do have detox services available. However, treatment typically cannot begin until after your detox is complete.
What Is Medication-Assisted Treatment?
A medication assisted treatment for drug addiction may be able to help you start treatment without suffering through the symptoms of withdrawal.
A Medication assisted treatment (MAT) program is most often used to treat substance use disorders such as alcohol, heroin, and prescription pain reliever (opiates) use.
Studies have shown that medication-assisted treatment can help you remain sober after treatment ends. These same studies have shown that MAT programs in addition to therapy are most successful in treating these types of substance use disorders.
The most commonly known medications used in these programs are:
For Alcohol Use
Naltrexone may be the most commonly known medication for alcohol use disorders. However, acamprosate and disulfiram are also regularly used by medication prescribers.
These medications do not provide a cure for alcohol use disorder. They may help in curbing your desire to drink as they have effects such as blocking the feelings and effects alcohol typically provides.
For Opioid and Heroin Use
Methadone may be the common medication that you have heard used for the treatment of opioid or heroin use. Other medications used by providers include buprenorphine and naltrexone.
These medications have been found to be safe to use for months and even years to keep people safe and sober.
However, as with any medication, you will want to consult with your doctor before beginning or discontinuing use.
Substance Use and Mental Health: What Are Co-occurring Disorders?
Co-occurring disorders are the existence of both a mental health diagnosis and a substance use diagnosis. It has been found that people who have a current mental health diagnosis are more likely to be affected by a substance use disorder than those without.
At times, co-occurring disorders can be difficult to diagnose. This is because symptoms of substance use disorders can overlap with symptoms of mental health disorders.
When symptoms overlap like this, it can be hard for clinicians to determine the root cause.
Another thing that can happen is that people struggling with mental health conditions do not address substance use in their lives. They may not believe it is at a problematic level. Or, they may not be at a place where they are willing to yet confront it.
Common Co-occurring Disorders
There are some co-occurring disorders that are seen more often in therapy and treatment. These include the following mental health diagnoses:
- Anxiety disorders
- Mood disorders
- Bipolar disorders
- Major Depressive Disorder
- Post-traumatic Stress Disorder (PTSD)
- Attention Deficit Disorder (ADHD)
Patients who have a mental health diagnosis are often seen for misuse of the following substances:
- Prescription Drugs
Does Insurance Cover Substance Use Treatment?
Insurance coverage is a concern for many who consider attending substance use treatment, whether you are attending an inpatient program, outpatient program, or IOP. Most insurance companies cover substance use treatment, at least to some degree.
The amount covered by your insurance company will depend on a number of things, such as your policy’s specifications and your treatment needs.
You will always want to contact your insurance company before attending treatment to learn about your coverage. You will want to ask how much your insurance company will be covering and how much you will be responsible for out-of-pocket.
Most inpatient and intensive outpatient programs require pre-authorization from your insurance provider. A therapist or representative from your treatment program will contact your insurance company on your behalf to obtain this pre-authorization after your initial intake appointment.
It cannot be done before this point because the therapist has to complete your evaluation to be able to give their recommendation of treatment level to the insurance provider.
Outpatient treatment services do not typically need a pre-authorization for substance use care. However, it is always best to check with your insurance company to be certain you know their requirements and coverage.
Can You Work While in Treatment?
Working while in treatment is possible during both Outpatient and Intensive Outpatient programs.
During OP treatment, you are only required to be in group therapy and individual therapy once a week. Some OP treatment programs require AA or other recovery program attendance as well.
However, even with this additional requirement, it is possible to work these around your employment schedule.
Intensive Outpatient treatment is certainly more of a time commitment, but even with three group sessions and an individual therapy session, it tops out at ten hours a week. Most IOP participants are able to make arrangements with their employers to work while in treatment.
Inpatient treatment requires you to live in a facility for a set amount of time. You may be able to take a short leave of absence from work, but you will need to make some type of arrangement to be away from work while you are in residential treatment.
Is Substance Use Treatment Effective?
Many who consider attending substance use treatment wonder if it is worth the time and effort they will need to put in. Thankfully, studies show that relapse in the first year after inpatient treatment is as low as thirty-seven percent.
This same research shows that those who attended outpatient care after leaving residential treatment had improved statistics than these.
There are also studies that show that IOP treatment is just as effective as residential treatment.
It was apparent in this research that part of what made IOP so effective is that it allows you to remain at home, in your regular environment while in treatment. This means the adjustment to be made when treatment ends are minimal compared to that of coming home from inpatient treatment.
IOP is set up in such a way that helps you make adjustments to your life and environment while you are in treatment. You can talk with your therapist about difficulties that happen in real-time.
You can confront the triggers and cravings you will be facing every day. This will help you address these both in group therapy and individual sessions.
Most IOP groups also ask that you connect with an AA Recovery group or Smart Recovery program. This way, you already have that support set up in your community when treatment ends.
What if You’re Required to Attend Treatment?
If attending a treatment program is a necessity for you and not a choice, know that treatment can still be effective.
Studies show that substance use treatment completed by those who are court-ordered is just as effective as people who are attending voluntarily.
These same studies actually showed that court-ordered participants tend to have high completion rates in treatment. They complete treatment more often than the people who are there voluntarily.
It has also been shown that going to treatment can help build up a person’s desire to stop using drugs or alcohol. Treatment can also create a true desire to change.
Furthermore, research conducted by the Bureau of Prisons that their RDAP (Residential Drug Abuse Program) shows lower relapse rates among those who participate in the program.
The study also seemed to show a correlation between participation in the RDAP program and continued life changes after leaving prison.
Why Do You Have to Take Part in Group Therapy While in Treatment?
Group therapy is an important part of substance use treatment as it is one of the places you begin both learning and practicing relapse prevention strategies.
Group therapy also helps you to build interpersonal skills so that you will be more comfortable building a sober social support network in your home environment. Group therapy gives its members a safe place to practice these interpersonal effectiveness skills.
This can be especially true when difficulties arise between group members and must be addressed. Members have their new skills to draw from as well as the support of their fellow group attendees and group facilitators to help them effectively and successfully work through difficult conversations.
Group therapy is also helpful in allowing you to feel connected with others while in residential treatment. Social isolation has been shown to be as harmful to humans as smoking up to fifteen cigarettes per day.
It can be helpful to know you are not alone and you are not the only one struggling with issues related to substance use.
How Do I Find the Right Treatment Program for Me?
If you have read through this information and are left with questions like, “How do I find inpatient drug treatment centers near me?” or “Is there an intensive outpatient program near me?” the answer may be closer than you think.
A quick internet search will most likely bring up a list of treatment centers, most even within your state or even a nearby area.
Now how do you figure out which treatment program will be a good fit for you? Here are some things to consider:
- Make sure they are licensed and accredited
- Ask what type of therapy they use (a few they may mention are Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Motivational Interviewing
- Ask what their programming looks like
- If you have any specific needs, ask if they can meet those needs (if you have trauma to process, ask if they have therapists who specialize in helping you process trauma; if you have anxiety or depression it is important the facility works with an addiction psychiatrist)
If you will be attending Outpatient or IOP treatment, you will want to try to find a program that is within driving distance of your home and workplace.
Alternately, if you will be living in an inpatient facility, you may want to visit the site before deciding on attending treatment there, if possible. This will allow you to see if you feel comfortable and potentially allow you to meet a few staff members.
You might search for “inpatient drug treatment centers near me,” “dialectical behavior therapy near me,” “residential addiction treatment,” or “new jersey addiction treatment” to find the best fit for treatment centers near you.
Are You Ready to Beat Your Addiction?
Is substance use negatively impacting your life? Are you ready to make changes with an Inpatient, Outpatient, or IOP program?
No matter which program is the right fit for you, we can help. Substance use treatment is effective and can help give you the new beginning you are desperately seeking.
Let us help you make the fresh start you need. Fill out the form here and we’ll get back to you as quickly as possible.